CAMPO

O

RESPOSTA

ORGANIZATION REGISTRATION FORM

1

Your organizationhas read and agrees with the World Social Forum Charter of Principles? To read it click here.

*

(closed entry: one option answer)

( ) Yes

( ) No

2

Complete name of your organization* (use one of the languages of the website)

*

(open entry)

3

Abreviation:

(open entry)

4

Address:

*

(open entry)

5

Country*:

*

(closed entry – list of countries)

6

Continent*:

*

(closed entry: one option answer)

() America

() Asia

() Europe

() Africa

() Oceania

7

Phone/Fax number (internetional code – local code - phone)*:

*

(open entry)

8

E-mail of the organization*:

*

(open entry)

9

Website:

(open entry)

10

Range of action of the Organization:

(closed entry: one option answer)

() Global

() Continental

() National

() Regional

() Local

11

Type of organization*:

*

(closed entry: one option answer)

() International aid agency

()Class association

()Research Center / universities

()Cooperative

()Religious / inter-religious entity

()Corporate non-profit organization

( ) Social Movements (including student and youth movements)

()NGO

()Network / coalition/ campaign / forum

()Trade Union

() Corporate groups / Platforms

( )Others. Describe (open entry)

12

Chose one of the following languages to receive further information*:

*

(closed entry: one option answer)

() Portuguese

() English

() French

() Spanish

13

Name of person specifically responsible for registering*:

*

(open entry)

(name) (last name)

14

E-mail ofperson specifically responsible for registering*:

*

(open entry)

there is also the list of people listed in

14B

Do you want to be contactedas organizations though the site

Nt

(closed entry: one option answer

( ) Yes by organisationor activity users only

() yes by organisaiton activityand individual users

( ) No

14C

E-mail of persons that will be copied when someone contacts the organisations

*

(open entry)

15

Gender:

(closed entry: one option answer)

() Male

() Female

16

Should we include person responsible for registering as participant*?

*

(closed entry: one option answer)

( ) Yes

( ) No

@@16B

@ 4 What is the profile of your organization's participation in WSF2011 - in and out of Dakar?

If answer 2 in ORG-16B-2 then there cannot be answer 1 in ACT –1C-1

(closed entry: answer can be 1, 2, 2+3)

( 1) We will be presentin Dakar as organizationand pay the full organization fee

( 2)We will be present out of Dakar as organization and will interface for organizeup to 3? distance encounter or distance participation activities, maybe with other partner organizationsand pay the “reduced organization fee” for distance participation ( to be defined)

( 3)also We will have delegate in Dakar registering as person who will help in distance intercomunicaiton( give link to“persuer” of delegate?)

16C

Foster contribution of organization to wsf facilitation

There can be a list of some wsf2011 groups and commission with the requisite and tasks

Indicating if remote participation is possible for organization not in Dakar

(closed entry: answer can be 1, 2, 3, 2+3, inputs in case of 2 or 3)

(1) we wont /cant contibrute

(2) We have intention to contribute to facilitating the WSF211 with volunteers working in the OC( in and out of Dakar for some groups)

ÿ indicate which group in alist?) – give persuser of person

(3) We have intention to contribute to facilitate the WSF2011 in commissions with presence of CO ( in and out of Dakar)

ÿ (statewhich commission in a list?) – give persuserof person

17

The WSF Methodology expects that Thematic Assemblies are going to be held in the last two days of the 2011 WSF (10 and 11/02/2011), please click here formore information.

(closed entry: answer can be tdb)

Intentions and interests

(1) we are intending to co-organize an assembly when in Dakar

(2) we are intending to co-organize an assembly while not in Dakar ??

(3) we are interested to participate in assemblies when in Dakar

(4) we are interested to participate in assemblies from outside Dakar

Numerous Distance participation in assemblies is a relevantissue to be tackled by assembly organizers in dakar

18

Does your organization need a stall?

In case it does, click here for the Registration form for Stalls.

19

Indicate the activities in which your organization is involved

(link format+ opencomment zone – adding lines as necessary Give a link to an activity form url in wsf2011 can be controlled( several lines possible )allow navigation inside the site between activity page and organizations page

20

Indicate the assemblies thatyour organization is/ has co-organized

(after the wsf Is started/over)

(link format+ opencomment zone – adding lines as necessary Give a link to an activity form url in wsf2011- assembly nature of link can be controlled( several lines possible ) allow navigation inside the site between activity page and organizations page

21

Outcomes proposals you are involved in as partner

(after the wsf Is started/over)

*

(link format+ opencomment zone – adding lines as necessary Edit link (up to 3) to outcome proposal pages in wsf2011 that you promote asorganizations – and comment your relation to them proposal nature of link can be controlled

22

Reports about your participationas organization

(after the wsf Is started/over)

*

(link format+ opencomment zone – adding lines as necessary Edit link (up to 3) to url where your organisaiton report documentaboutwsf2011 can be found– and comment your relation to them

23

Outcomes proposals that you endorse as organization

(after the wsf Is started/over)

*

(link format+ opencomment zone – adding lines as necessary Edit link (up to 3) to outcome proposal pages in wsf2011 that you endorse as organizations – and comment your relation to them

proposalnature of link can be controlled

24

Feedbackas organization

(after the wsf Is started/over)

*

(link format+ opencomment zone – and or answering a inquiry with closed questions

What is your feedback as organisations

• see the doc sfex activity type
• en espanol
• en francais
  

*

REGISTRATION FORM FOR ACTIVITIES

1

Title of activity *:

*

(open entry– up to 255 characters)

1B

Partners organizations for this activity

The registering organization relating with OC is doing this in the name of all partners

*

(open entry– up to 255 characters)andpossibility to edit two links by entrythe org website link and the organization form url in the wsf2011 site (in order to see that all organization mentioned areregisteredand allow navigation inside the site between activity page and organizations page

1B1

Do you want a neutral activity user for this activity , able to edit the activity form

When there are a lot of partners, it may be delicate to have only one orguser able to edit the activity form

*

(closed entry: one option answer)

(yes)a new user is created that can specificallyedit this activity , name and code are sent to all people listed in ACT -6B

(no ) only the original registeringorguser can edit this activity

@@1C

Location of activity (in or out of Dakar) and time if out of dakar*:

*

(closed entry: one option answer + additional fieldsappearing in case of answers 2 3 4)

ÿ 1 local activity in Dakar ( classical programming)

ÿ 2 local activity out of Dakar ( no programming)

ÿ Indicate place out of Dakar ( address city etc..)

ÿ(country)

ÿ Indicate Dakar and local days and hours of time and duration

ÿ 3 activity Both in and out of Dakar - a room in Dakar expanded and somewhere else in the world)( dakar expanded programming)

ÿ Indicate place out of Dakar( address city etc..)

ÿ(country)

ÿ Indicate Dakar and local days and hours of time and duration

ÿ 4 activity Both in and out of Dakar - distance participation from aroom inDakar expanded and with an activity outside dakar( dakar expanded programming)

ÿ Indicate place out of Dakar( address city etc..)(country)

ÿ Indicate day and time in dakar, Indicate duration

Indicate day an time and in other place

@@1D

Commented Relation with otheractivities -*:

*

(link format+ opencomment zone – adding lines as necessary ( several lines possible)( see example list) – those links allow richer navigation inside the site between activities, and show the associations between local and intercommunication activities , and distance participation linkages

@@1E

Connectivity and rooms allocation for this activity( in or out ofDakar) :

‘*)Extensionmeans ( organizing " instant video and messaging " to allow vision (via video) and inputs (via messaging or phone) for distant participant– it is possible to receive information / distance training from Dakar expanded group(see item9 below)

(**)Secondary connection means that if the connection fails to be establishedthe activity still goes on

*

(closed entry: one option answer + additional link fields in answer 4 and 5)

ÿ 1 Activity face to face without any connectivity (in or out of Dakar)

ÿ 2 Activity face to face with “secondary” (**)possibility of connecting from a distance or with extension (*) for distance participation (in or out of Dakar) – need for internet

ÿ 3 Distance encounter between an equipped dakar-expanded room and another place (with possibility ofextension(*)

ÿ 4 Collective distance Participation of a group out of Dakar: in an activity in Dakar welcoming it(*)(

ÿ (insert name of activity-location is at the links) (

ÿ 5 Collective distance Participation in Dakar expanded room: a group in Dakar attending a activity out of Dakar welcoming it (*)

ÿ (insert name of activity / location is in the links)

2

Type of activity *:

*

(closed entry: one option answer)

a) Cultural or Artistic Activity (by chosing this answer, a specific list of options is opened beneath, one must be chosen:)

a1) visual arts exposition

a2) audiovisual

a3) music presentation

a4) theater

a5) poetry

a6) party

a7) celebration

b) March

c) Conference

d) Dialog round table

e) Controversy round table

f) Newspaperl/Radio/TV

g) Manifestation

h) Workshop

i) Panel

j) Research

k) Meeting

l) Seminar

m) Testimonials

@@n1) Meeting between several distant groups

@@N2 Participating collectively from adistance to another activity)

o) Other. Describe: (text entry – up until 50 characters)

3

Short description of the activity's program*

*

(open entry, up to 1.000 characters)

4

Provide names of already confirmed panelists (when existing), that willexpose or make contributions.

Or also expose how your activity will be participatory or use “other languages” than analytic speech

(open entry for listing)

5

Among the several struggle objectives below, which one is closer to your activity?*

*

(closed entry: one option answer)

() Axes 1

() Axes 2

() Axes 3

() Axes 4

() Axes 5

() Axes 6

() Axes 7

() Axes 8

() Axes 9

() Axes 10

() Axes 11 – activities on the WSF process.

6

We want to be contacted by other organizations for collaborations regarding this activity:

Messages will go to the list of people indacted in 6B

*

(closed entry: one option answer)should allow contacting the person through wsf2011 without knowing her address)

( ) Yes by organisationor activity users only

() yes by organisaiton activityand individual users

( ) No

6B

Which are the other names that will receive the contact messages sent to this activity though the website( from other orgusers, activity users

*

(list of persusers, or emails )should allow contacting various persons from various co-organizers of the activity( can be even automatically manage through 1B

7

Provide a link (URL) to the virtual space of preparation and mobilization of this activity – prior to the event (space of collaborative work). This space can also serve as memory and follow up after the event (it can be an OpenFSM space, a blog, a website etc.):

(link format)has to appear as an active link in the activity page in wsf2011 site

7B

7B comment on how you will prepare or will report

*

(open entry )- + comment field

7C

Outcome /Proposals linked to this activity

*

Link to an outcome form url ( if there isdecision to have expression of outcomes /proposals- + comment field

(several lines possible)

8

Prefered date*forlocal activities in dakar(appears if answer 1 in question 1C)

*

(closed entry: one option answer)

() 07 African Day / Diaspora Day

() 08

() 09

() Any

9

In how many shifts will your activity going to be held?* for local activities in Dakar (appears if answer 1 in question 1C)

*

(closed entry: one option answer)

()1 shift

()2 shifts

()3 shifts

()4 shifts (by chosing this option it won't be able to register other activity.

10

What's your prefered shift*for local activities in Dakar (appears if answer 1 in question 1C)

*

(closed entry: one option answer according to the previous answer)

() Shift 1 (08h30 to 11h30)

() Shift 2 (12h to 15h)

() Shift 3 (15h30 to 18h30)

() Shift 4 (19h to 22h)

11

Do you need interpretation?For all activities in Dakar and distance encounter or participation

(appears if answer 1 3 4 in 1C )

*

(closed entry: one option answer)

( ) Yes

( ) No

12

If you do, for how many languages? For all activities in Dakar and distance encounter or participation

(appears if answer 1 3 4 in 1C )

From which language

(open or closed entry?)

() (list of options)

(more than one option possible?)

To which language?

(open or closed entry?)

() (list of options)

(more than one option possible?)

13

Which language will be used by panelists of your proposed activity?

(appears if in cases of activities in and out of Dakar except 4 and 5 in question 1C)

*

(closed entry, multiple answers possible)

() German

() Arab

() Korean

() Spanish

() French

() Guarani

() Hebrew

() Hindi

() English

() Italian

() Japonese

() Portuguese

() Quechua

() Swahili / Kiswahili

()Wolof

() Other. Which? _________

14A

Estimate public for this activity? (in Dakar)*( appears if answer 1 3 4 in question 1C)

*

(closed entry: one option answer)

(1…) not relevant

() less than 15 people

() 15-30

() 30-50

() 50-100

() 100-150

() 150-300

()more than 300

@@14B

Estimate public for this activity? ( outside Dakar (appears if answer 2 3in questions 1C)

*

(closed entry: one option answer)

(1…) not relevant

() less than 15 people

() 15-30

() 30-50

() 50-100

() 100-150

() 150-300

()more than 300

@@14C

(for all cases)

Are you willing to organize "expansion" of your activity ( from in or out of Dakar)to make possible distance “real time” viewing listingand alsodistance participation , through a return ( out or in dakar, or elsewere in the world)

If answer is “yes” here, it cannot be 1 in question 1E- coherence check when saving with a feedback message

Note: Distance participation in assemblies is a relevantissue to be tackled by assembly organizers in Dakar ( to be discussed in ASY form )

*

(has to be at least one in 1234 plus at least one one in 567 )

(1 )No

(2 ) yeswe are providinginstantaneous video streaming

(3 )yeswe are providinginstantaneous audio streaming/

(4 ) yeswe are providinginstantaneous radio broadcasting

· indicate, the channel video or audio (eg in www.ustream.tv)

· Indicate the name of the streaming media if your streaming isnot self organized

Self organized the streaming Needs a room with two computers for internet with a webcam and microphone, and the two dedicated people fimajem the local messenger and make contact - and possible to have Early Training information by the group expanded Dakar)

(.5. )we are not providing aparticipation return

(.6 )we are providing participation return via instantaneous messaging( welcoming up to 100 people in a chat room)

(.7. ) Yes with participationreturn via telephone (with a community radio

· Indicate and the name of the “bridgingperson” of the public "instantaneous local messenger contact or phone number (eg at www.skype.com)( can be several for different languages/groups)

· Indicate the name of the community radio -

· Indicate the language that you will be outputting,and what language the bridging persons will beunderstanding in the return

15

(open this entry appears if answer 2 34 5 in questions 1E)

Comment on the any expanded aspect, intercommunication aspect .

*

(open entry)

@@15B

(open this entry appears if answer 2 34 5 in questions 1E)

indicate pers user contact for technical preparation of connexion of the activity .

*

List of persuser contacts ?

16

Any message you want to express to OC

*

(open entry)

17

Report on the activity proceeding-

*

Figure Actual public ( number format )

(link format+ opencomment zone –

Summary and link to Memory notes

INDIVIDUAL PARTICIPANTS REGISTRATION FORM

1

Name / Last name*:

*

(open entry)

2

City*:

*

(open entry)

3

State/Province*:

*

(open entry)

4

Country*:

*

(open entry)

5

E-mail*:

*

(open entry)

6

Phone number (country code – local code - number)*:

*

(open entry)

7

Gender*:

*

(campo fechado para escolha de uma opção)

() Male

() Female

@@7B

Type of indiviudal participation

*

(campo fechado para escolha de uma opção)

( 1) i will be in dakar and pay the participant fee

(2 ) I will be out of dakar andwill participate in local activities in my town, or in collective distance participation activities

(3) i will be out of dakar and as distant participantor followers of activities on the internet

8

(only in case of IND-7B-1) Number of identification document (passport)*:

In case you need an invitation letter for obtaining a Senegalese Visa, please click here.

*

(open entry)

8 B

What languages do you speak*:

*

(open entry for multiple answers possible)

() Portuguese

() English

() French

() Spanish

() Arab

() Wolof

() Other? Which _________l

9

Chose one of the following languages for receiving further information: *

*

(closed entry: one option answer)

() Portuguese

() English

() French

() Spanish

10

Age*:

*

(closed entry: one option answer)

() less than 16

() 16-25

() 26-35

() 36-45

() 46-55

() 56-65

() more than 66

11

Organizations you relate to

*

(link format+ opencomment zone – adding up to 3 lines Edit link to organization pages in wsf2011 to which you participate ( several lines) – and cmment your relation with them

12

Outcomes proposals you endorse as person

(after the wsf Is started/over)

*

(link format+ opencomment zone – adding up to 3 lines Edit link to outcome proposal pages in wsf2011 that you endorse – and comment your relation to them

13

Activities you were involved inwsf2011

(after the wsf Is started/over)

*

(link format+ opencomment zone – adding up to 3 lines Edit link to activities wheremajor experiences,you have had and express comments

14

Your inputson/inwsf2011

(after the wsf Is started/over)

*

(link format+ opencomment zone – adding up to 3 lines Edit link to document you have produced related to wsf2011 andexpress comments

15

Your feedbackon wsf2011

(after the wsf Is started/over)

*

(link format+ opencomment zone or closed questionnaireEdit link What is your feedback on wsf2011- short text and link

*

ASSEMBLY REGISTRATION FORM

To be discussed

*